Agenda Item:2
Ref: W07-08/216
Wirral Primary Care Trust
Mental Health Developments
Introduction
1.
This report provides the Board with an overview of planned developments in mental health
services in Wirral. Mental Health has been identified as a key priority within the PCT
Commissioning Strategy and work is underway to develop detailed plans for implementation in
key areas.
Key Areas for Development
2.
These are:
 Primary Care Mental Health Services
 Children and Adolescent Mental Health Services
 Improving Access to Psychological Services in specialist services
 Services for people with Early Onset Dementia, including Alcohol Related Brain
Damage (ARBD)
 Services for Adults with Attention Deficit Hyperactivity Disorder (ADHD)
 Psychiatric Liaison Services
 Dementia Services
Further Detail on Service Areas
Primary Care Mental Health Services
3.
Following a review of these services, a detailed implementation plan is now being developed.
These services are currently provided by Wirral PCT Provider services and Cheshire and Wirral
Partnership Trust. Based on the work of the review and the high national priority of Improving
Access to Psychological Therapies, there is a need to develop a new service, which will require
new ways of working, within an agreed pathway, and considerable investment in terms of the
workforce required to meet national standards for delivery. These standards include the
requirement for all who need the service to be seen and assessed within ten days of referral. It is
estimated that approximately 10,500 people in Wirral will need to access this service every year.
4.
It is also intended that the service will ‘signpost’ and have very clear links with a range of lowlevel intervention support and advice services, provided mainly by the Third Sector. This will
include ‘Social Prescribing’ activities, including exercise on prescription, ‘Get into Reading’, debt
and welfare benefits advice and a range of other community-based supports.
5.
Following the presentation of a report to the Professional Executive Committee on 19 February,
it has been agreed to tender for this new service.
Children’s and Adolescent Mental Health Services
6.
Significant future investment in these services, provided by Cheshire and Wirral Partnership
Trust in partnership with the Local Authority, has been agreed in line with the PCT
Commissioning Strategy. The development plans also include:
 Establishing a multi-systemic therapy programme
 Improving psychological input in schools
 Provision of ‘wrap around’ intensive home support for those with the most complex
needs
Mental Health Developments: Board Meeting 11 March 2008
1/3
Wirral PCT
Agenda Item:2
Ref: W07-08/216
Improving Access to Psychological Services in Specialist Services
7.
Based on the recommendations contained with the review of these services, there is an intention
to:
 Develop provision of psychological interventions in in-patient services.
 Enhance the local model of delivery of Eating Disorder Services via sessional input
from Consultant Psychiatrist.
Services for people with Early Onset Dementia, including Alcohol Related Brain Damage
8.
Services for people with Early Onset Dementia require development in order to meet local need.
There are an emerging and increasing number of people with Alcohol Related Brain Damage
whose discharges from acute hospital care are significantly delayed. In addition, the current
service for people with Early Onset Dementia does not have sufficient capacity to provide an
assessment and care management for this particular group. In the past, this has led to
difficulties in establishing case responsibility and the appropriate pathway for people with this
particular need. It is anticipated that there will be a further increase in the numbers of people
experiencing Alcohol Related Brain Damage in the future.
9.
It is therefore intended to:
 Enhance the current Early Onset Dementia service (currently two staff with sessional
Consultant Psychiatrist input). Plans are in development with Cheshire and Wirral
Partnership Trust and Wirral DASS to achieve this, allowing a broadening of the service
criteria.
 Develop day care services for people with Early Onset Dementia in partnership with
Age Concern, and with specialist and skilled inreach from qualified nursing staff via
Cheshire and Wirral Partnership Trust.
Services for Adults with Attention Hyperactivity Deficit Disorder
10.
Until very recently, there was no service in place for this group, beyond the age of nineteen.
However, there are a small number of people, either already known to Children’s or Paediatric
Services, or adults presenting at their GPs, who need this service into adulthood. Current
prescribing regulations are clear, in that medication must be initiated by a Consultant
Psychiatrist. Work has therefore been undertaken with Cheshire and Wirral Partnership Trust, to
‘test out’ an assessment and follow-up clinic with a small group of patients and a Project Team
has been established to develop a locally agreed model of care. It is anticipated that NICE
guidance will be published later this year in this area, which will act a further driver to establish
this service locally.
Psychiatric Liaison Services
11.
The PCT has commissioned a review of this service, provided by Cheshire and Wirral
Partnership Trust. There were a number of reasons for this:
 Internal inquiry into Homicide
 Maternity Services Review
 Review agreed within the Contract with Cheshire and Wirral Partnership Trust
12.
The review will be completed at the end of March, when a full report will be available,
accompanied by a detailed and revised service specification. During the course of the review,
interim arrangements have been agreed with Cheshire and Wirral Partnership Trust to extend
this service to provide cover for twelve hours per day, seven days per week.
Mental Health Developments: Board Meeting 11 March 2008
2/3
Wirral PCT
Agenda Item:2
Ref: W07-08/216
Development of Pathway for Dementia
13.
The PCT has commissioned a Project Manager to develop a whole system pathway for
dementia care, acknowledging the anticipated incidence and increase of dementia within the
population of Wirral. The pathway will extend from first identification to end of life, and it is
intended that the pathway be linked to the Map of Medicine.
14.
A range of different methods have been used so far to consult with key stakeholders, including
users and carers, and a workshop was held on 5 March to inform the ‘ideal’ pathway and
strategic developments necessary. A full report will be available on this work at the end of April.
Recommendation
15.
The Board is asked to note the contents of this report.
Debbie Mayor
Joint Commissioning Manager, Mental Health
18 February, 2008
Mental Health Developments: Board Meeting 11 March 2008
3/3